Provider Demographics
NPI:1205085131
Name:DASARI, ALLISON MARIE (DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:DASARI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MARIE
Other - Last Name:DIETSCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 UNIVERSITY AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:612-884-3592
Practice Address - Street 1:1390 UNIVERSITY AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4001
Practice Address - Country:US
Practice Address - Phone:651-232-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60025162225100000X
MN9162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist